Welcome to ‘On the Table’ – UPMC Sports Surgery Clinic’s orthopaedic advances podcast hosted by Dr Andy Franklyn-Miller, Consultant Sports & Exercise Medicine Physician at SSC. The purpose of the podcast is to explore the reasons behind making a decision to operate in common orthopaedic conditions and explore the latest evidence and post-operative strategies.

In Episode Six, we are delighted to speak to Ms Ann-Maria Byrne, Consultant Orthopaedic Surgeon at UPMC Sports Surgery Clinic and specialist in elbow, hand and wrist surgery.

This episode focuses on the topic of decision making around the biceps and common extensor origin injuries and surgical indications.

Shownotes:

5:09
Distal biceps ruptures certainly seem to be increasingly common, anecdotally one always thinks anabolic steroid use, but the mechanism is more varied?

8:10
Is there commonly tendinopathy or avulsion?

11:38
What is the mechanism of injury in rupture?

13:04
How do you go about the clinical assessment is this something you use to differentiate between partial and complete tears? What are the decision making steps in deciding to operate?

16:58
Does MRI help or hinder decision making?

18:38
What does biceps surgery involve?

23:12
And what does the post-operative period look like?

27:17
When can they lift heavy again?

29:09
What are the complications of surgery

32:02
When does contact sport come back?

33:51
Common Extensor Origin tendinopathy, what does the evidence suggest?

37:41
What are the differential diagnosis before surgery?

44:52
When can surgery assist?

45:22
Matache published a protocol for a sham RCT of arthroscopic release using DASH (Disability of Shoulder and Hand) and Mayo Elbow Performance Score (MEPS) not all our listeners will be familiar with DASH and MEPS are these well accepted PROMS that can use to track improvement?

Papers mentioned in the podcast

Platelet-Rich-Plasma Injections in Treating Lateral Epicondylosis: a Review of the Recent Evidence.
Murray DJ, Javed S, Jain N, Kemp S, Watts AC.
J Hand Microsurg. 2015 Dec;7(2):320-5. doi: 10.1007/s12593-015-0193-3. Epub 2015 Jul 8. Review.

Matache BA, Berdusco R, Momoli F, Lapner PL, Pollock JW. A randomized, double-blind sham-controlled trial on the efficacy of arthroscopic tennis elbow release for the management of chronic lateral epicondylitis. BMC Musculoskelet Disord. 2016;17:239. Published 2016 Jun 1. doi:10.1186/s12891-016-1093-9

About Ms Byrne

Ms Ann-Maria Byrne’s clinic is based in UPMC Sports Surgery Clinic’s Northwood Suite in Santry.
Her secretary is Niamh Kennedy
Phone: +353 1 5262345
Email:ambyrneadmin@sportssurgeryclinic.com